Single-J versus double-J stents after ureterorenoscopy for renal stones: A randomized comparison of safety and tolerability.

Abstract

Introduction: Ureteral stents are generally used after ureterorenoscopy (URS) procedures, even in uncomplicated ones. We aimed to compare the safety and tolerability of single-J (SJ) stents and double-J (DJ) stents in patients submitted to flexible URS for renal stones.

Material and methods: This prospective, randomized, unblinded, single-center study was conducted between July 2022 and May 2024, involving patients undergoing flexible URS with holmium laser lithotripsy for renal stones. Patients were randomized to either SJ stents (removed within 24 hours) or DJ stents (removed 2-4 weeks post-surgery). Primary endpoints included emergency department admissions, postoperative complications, and reintervention rates. Secondary endpoints included stent tolerability and surgery efficacy. A symptom questionnaire was applied at postoperative weeks 1 (W1) and 4 (W4).

Results: We included 125 patients (60 in group SJ and 65 in group DJ), with comparable baseline characteristics. Emergency department admissions were similar (18.3% vs 16.9%, p = 0.84), as were complications (18.3% vs 21.5%, p = 0.65) and reintervention rates (1.7% vs 3.1%, p = 1.0). SJ stents showed better tolerability, with lower scores for lower urinary tract symptoms (LUTS) and pain at both time points.

Conclusions: SJ stents placed for less than 24 hours after complete flexible URS are comparable to DJ stents regarding safety and are better tolerated, particularly 4 weeks after the surgery. SJ stents should be prioritized, reducing costs and hospital visits for stent removal.